National Project Implementation Plan - NVBDCP

Chapter 8
Impact Evaluation
The impact evaluation studies conducted under the NVBDCP will generate
evidence to assist in the realization of two important goals in disease control
efforts: (1) to provide timely diagnosis and treatment services for malaria
control, most notably through the introduction of ACT in endemic areas. (2) to
increase the number of people benefiting from effective prevention, including
the promotion of LLINs. Impact evaluation will be used to investigate the
effectiveness and cost-effectiveness of alternative strategies in disease control
efforts to be evaluated for ongoing NVBDCP activities and this will be
conducted in the first two years of the project to inform policy going forward.
The summary of the interventions, for case management and for involving the
distribution of LLINs are described below:
8.1 Case management
Technical Advisory Committee (TAC) in 2008 has approved the use of
Artesunate Combination therapy (ACT) for all confirmed diagnosed
P.falciparum cases in 50 districts under the World Bank project. NVBDCP has
introduced the revised policy for malaria diagnosis and treatment to all the
states including states under GFATM and the World Bank. With the help of the
existing structures of the NRHM, ASHA or other Voluntary Health workers
already available at the village level will serve as the local frontline
representative for fever/malaria control and will dispense ACT to P. falciparum
confirmed fever cases. To assist the ASHA in her efforts, the NVBDCP has
positioned Malaria Technical Supervisor (MTS), who will be fully devoted to the
control of malaria in high-burden areas. As per implementation arrangement,
NVPDCP will hire around 6 MTS at the district level who will together support
the work of roughly 450-500 ASHA workers.
ASHAs responsibilities are numerous, including family planning, nutrition, and
vaccination. These multiple jobs raise the distinct possibility of underperformance
concerning malaria treatment and control. The case management
component of the impact evaluation will evaluate the effectiveness and costeffectiveness
of enhanced saturation by MTS to supervise the ASHA worker on
a more regular basis in order to explore whether and to what extent ASHA
performance will benefit from more intensive training and supervision. Under
this design, two Malaria Technical Supervisors (MTS) will be posted at the block
level and each individually will be responsible for 75 ASHA workers. This ratio
of MTS to ASHA workers ensures that the travel burden of each MTS will be
greatly reduced and that each ASHA worker will be directly supervised at least
once monthly. Supervision will also include BCC for villagers in her catchment
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